Thought stopping, either through shouting "STOP" or snapping a rubber band in response to the spike is not recommended and may be detrimental. As discussed previously, this technique would, in effect, sensitize the brain to the unwanted thought by alerting the "R" that potential punishment is associated with the spike. Theoretically, the spikes would thus increase due to this heightened sensitivity. Future research may bare this out.
Although logically pointing out the absurdity of the "Pure-O's" mental rituals is very tempting, it is often insulting and clearly ineffective. You cannot "out-logic" OCD. Similarly, the use of analytic interpretations to provide insight is absurd and harmful. A person's natural inclination is to investigate what implications certain spikes might signify. A therapist who reinforces this inclination is naive and incompetent. Whether it be stabbing one's loved ones or having sex with one's mother, these thoughts will only become more deeply entrenched by placing emotionally laden meanings on them, such as underlying aggressive impulses or unresolved Oedipal conflicts.
Ultimately, as with all forms of OCD, living with uncertainty and risk taking are the antidotes to this disorder. The treatment of the "Pure-O" is theoretically based on the principles of classical conditioning and extinction. The person's intolerance for having bizarre and noxious thoughts only perpetuates the disorder. The efforts a person makes to avoid or escape these thoughts reinforces their recurrence. Therefore, the removal of the reinforcement (extinction) entails the following.
But first - a warning. Paradoxically, you will know the disorder is getting better when the frequency of spikes increases. Our brain is resistant to change. As one attempts to make space for thoughts that one has long spent great energy avoiding or trying to neutralize, our brain will meet this change with opposition. A common occurrence is that a person who previously would spike four times a day, but ruminate incessantly for the duration of the day, will often spike much more frequently, as their amount of rumination substantially decreases.
THE CRITICAL VARIABLE IS THE RUMINATION AND NOT THE NUMBER OF SPIKES!!! This statement is paramount for a successful treatment. The target response is having the person not respond to the spike, it is not to have the spikes go away. The long-term effect of not attending to the spike will be that the spikes will decrease in frequency and emotional intensity. This will happen only if the person desensitizes to these thoughts by allowing them to occur. A common phrase often mentioned in my groups is "let the thoughts be there," give yourself permission to have the thoughts. In conclusion, I offer four treatment suggestions. These procedures have been very successful in turning lives around and freeing up thoughts for contemplation of more meaningful material. The research is still preliminary, but the treatment outcomes have been significant enough to spread the word. As with all forms of OCD, behavioral therapy is effective to the extent that the subject adheres to the procedures